Pars Plana Vitrectomy as a Primary Treatment for Acute Bacterial Endophthalmitis

Purpose. To evaluate visual outcomes and identify prognostic factors after pars plana vitrectomy (PPV) surgery for traumatic endophthalmitis. Methods. Medical records of 121 consecutive patients (121 eyes) diagnosed with traumatic endophthalmitis that had undergone pars plana vitrectomy were retrospectively reviewed. Results. 121 patients, aged from 6 to 71 years, all underwent PPV surgery. 113 cases had improved best corrected visual acuity (BCVA) after surgery and 60% of them obtained BCVA better than fingers counting (FC). Good final visual prognosis was significantly associated with time between trauma and initial treatment less than 12 hrs (40% versus 98%; P<0.001), time between trauma and PPV treatment less than 24 hrs (62% versus 98%; P<0.001), laceration length less than 10 mm (63% versus 96%; P<0.001), and presenting VA better than LP (42% versus 96%; P<0.001), while gender, type of laceration, presence of IOFB or retinal detachment, and the use of silicone oil tamponade were not significant factors resulting in better BCVA. Bacteria were identified in 43.8% of specimens and most of the microorganisms were identified as nonvirulent ones. Conclusions. Pars plana vitrectomy surgery was preferred as a primary treatment option for traumatic endophthalmitis. A good final visual prognosis was significantly associated with timely treatment, prompt vitrectomy surgery, shorter length of laceration, and better presenting visual acuity.

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Sympathetic Ophthalmia After Pars Plana Vitrectomy-Lensectomy for Endogenous Bacterial Endophthalmitis

American Journal of Ophthalmology ◽

10.1016/0002-9394(81)90287-7 ◽

1981 ◽

Vol 91 (3) ◽

pp. 342-346 ◽

Cited By ~ 16

Author(s):

Juan O. Croxatto ◽

Paul Galentine ◽

Howard P. Cupples ◽

David Harper ◽

August Reader ◽

...

Keyword(s):

Pars Plana Vitrectomy ◽

Sympathetic Ophthalmia ◽

Bacterial Endophthalmitis ◽

Pars Plana ◽

Endogenous Bacterial Endophthalmitis

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Immediate Vitrectomy and Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0034 ◽

2020 ◽

pp. 207-212

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

Antibiotic Treatment ◽

Pars Plana Vitrectomy ◽

Length Of Hospital Stay ◽

Light Perception ◽

Systemic Antibiotic ◽

Bacterial Endophthalmitis ◽

Intravenous Antibiotics ◽

Pars Plana ◽

Clinical Signs And Symptoms ◽

Systemic Antibiotic Treatment

The Endophthalmitis Vitrectomy Study (EVS) was a randomized, controlled clinical trial to determine the roles of immediate pars plana vitrectomy and systemic antibiotic treatment in the management of postoperative endophthalmitis in patients with clinical signs and symptoms of bacterial endophthalmitis within 6 weeks of cataract surgery or secondary intraocular lens (IOL) implantation and visual acuity between 20/50 and light perception. The study found that routine immediate pars plana vitrectomy is not necessary in patients with better than light perception vision at presentation but is of substantial benefit for those who have light perception-only vision (or worse). Most patients do not require treatment with intravenous antibiotics. Omission of systemic antibiotic treatment can reduce toxic effects, costs, and length of hospital stay.

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